Australia 'Disgusted': More than 30,000 school children illegally X-rayed

00:57 04 august 2018

00:57 04 august 2018 Source:
msn.com

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"I'm actually quite disgusted that I was part of that," one former staff member, who travelled to rural schools as a sales rep in 2014, said upon learning that the company was not licensed to X - ray children .

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A mobile dental van run by a north-west Sydney company has exposed children as young as two to radiation without a license, and has been accused by former staff of exploiting Medicare and mistreating workers.

The case has highlighted the lack of transparency around the growing industry of private mobile dental clinics and raised fears within the peak dental body that the government will close down the "wonderful" Medicare dental scheme the company is accused of abusing.

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Earlier this month, Australian Aged Dental Care Pty Ltd pleaded guilty on the third day of its trial in the Downing Centre Local Court to administering radiation without a user license. However, its Smiles Onsite van has continued to operate since charges were laid in early 2016, seeing up to 150 students a week although no longer X-raying them.

Next month, the van will visit Lake Heights Public School in the Illawarra, Mudgee High School and Francis Greenway High School outside Newcastle. In recent months, they have treated students at schools from Tweed Heads to Cowra, and expanded into Victoria.

Fairfax Media has interviewed former staff members, officials with knowledge of the case and dental experts who have accused the company of questionable practices, including hiring underqualified staff, billing Medicare for procedures that weren't performed or weren't necessary, overworking and underpaying staff and dismissing workers who questioned the conpany's business practices. The company strongly denies such allegations.

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"I'm actually quite disgusted that I was part of that," one former staff member, who travelled to rural schools as a sales rep in 2014, said upon learning that the company was not licensed to X-ray children.

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Former operations manager Steven Venter said he raised concerns about school children operating a mechanical lift in and out of the mobile dental van.

In 2011, when the federal government had a Medicare benefit for the elderly, the company started sending mobile clinics to aged care homes to provide "free" dental care for residents.

When the benefit ended in 2012, the company rebranded the vans to take advantage of a new Medicare benefit scheme: the Child Dental Benefit Schedule.

The scheme gives eligible children, aged two to 17, $1000 worth of basic dental treatment over two years.

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Smiles Onsite has travelled to hundreds of schools around NSW, from Doonside Technology High School and Holsworthy High School in Sydney to rural schools like Cullen Bullen Public School and Canowindra High School, where they treated 400 students in 2014.

Staff have made the alarming accusation that, until the company was prosecuted, every child was X-rayed as soon as they entered the van by clinic managers who didn't have radiation licenses. Children and staff were not given proper protective wear and children were not asked if they had been X-rayed recently, potentially exposing some to years worth of radiation dosage in a short period, sources claimed.

Children would then see a dentist, often a qualified practitioner who was new to the country.

One former clinic manager, who spoke on condition of anonymity, said he applied for a job as a dental assistant in 2013 but was immediately put into a more senior role.

"The first thing I noticed was the X-rays, I wasn't sure if the walls were lead lined," he said. "I decided with some other clinicians to ask but the bosses ... got angry and said that we should just concentrate on our individual duties and leave other things to them."

He said company heads often monitored CCTV in the van and would call staff to tell them to hurry more students through.

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"There were a few times that I was called into [the] office to warn me that I had to see a certain amount of students in a day," he said. "If I didn't get that done then they will not roster me to work."

Another former employee, who asked to be moved from a dental assistant role to an administrative role because she wasn't given proper safety gear, claimed she was told to bill Medicare for procedures that weren't done or weren't necessary to perform. No charges have been laid by Medicare.

"I raised some issues and it was kind of like 'it's OK, we're not doing anything wrong'," she said. "I didn't have a full enough understanding in terms of what the actual items were. I actually ended up leaving because I just didn't ... feel like what they were doing was right."

A fourth employee, who worked in admin for a year, asserted her job was to access children's Medicare information using the Medicare provider numbers of five dentists who didn't work for the company.

"We would check every single child in a school to see if they were eligible [for the benefit]," she said. "They were the priority kids that would get treatment."

The former sales rep said she worked gruelling hours, driving between rural schools in her own car. The former clinic manager said he would often leave home at 4am to be at a rural school by 9am, then get home late at night.

"When I raised my concern the only reply was we can find someone else," he said.

Former operations manager, Steven Venter, said he complained vociferously last year when he wasn't paid superannuation or remuneration. A few days later, less than four weeks after he started, he was terminated.

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The EPA launched an investigation in late 2014 and raided the company's Castle Hill headquarters. They stopped X-raying children as a result but the vans have continued to treat students.

In a June letter sent to prospective investors, the company said they have expanded to five vans, 10 dentists, 40 support staff and see 30,000 patients each year.

Despite being briefed several times on the company's alleged conduct, the Department of Education only circulated an internal memo in April 2016 saying the company had been charged with radiation offences and principals should use their discretion.

The memo, based on advice from NSW Health’s Office of Oral Health Strategy, said it was "unclear" if the X-rays were necessary and there is "no evidence that these X-rays have been done in a way to endanger children".

A spokesman for NSW Health revealed that, as early as December 2013, the Australian Dental Association raised concerns around the lack of informed consent and improper use of the Child Dental Benefit Schedule by mobile dental providers.

In advice passed on to schools, the ADA strongly advised parents to choose a local dentist who is accessible for future appointments, to attend visits, to make sure X-rays aren't taken unless necessary and to make sure "only services actually provided are claimed from Medicare ... to ensure that the child receives the benefit of their full entitlement under the CDBS".

Australian Dental Association's advice for parents and schools by Rachel Olding on Scribd

Dr Neil Peppitt, president of the ADA's NSW branch, told Fairfax Media that the CDBS was a "wonderful" scheme but there were "concerns about some private mobile dental services that conduct visits in isolation to schools and child-care centres".

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which is unregulated by the government.[4] In Bombay, 50, 000 children are illegally employed by Thirty percent had been to elementary school , while only 10 percent had been to middle or high Older children and children with higher incomes were abused more than younger children and

"The ADA unequivocally supports the prosecution of anyone suspected of abusing the system," Dr Peppitt said.

In 2015, the federal health department issued a directive to the company to stop implying in their publicity and forms that they were a government service, the NSW Health spokesman said.

Lake Heights Primary School principal Peter Heddles expressed surprise at the X-ray prosecution but said he would still let the van come in August unless the Department of Education advised him otherwise. He said he never received any departmental memos and previous visits had been positive.

"We're very happy to have them back," he said. "All the people we had were lovely and the parents really appreciated it."

Education Minister Rob Stokes said he was "appalled and angry" that the mobile service "potentially put a group of NSW school students at risk by using ... unlicensed X-ray operators".

"Fortunately, health professionals view the risks to long-term health as very small, but it is unacceptable that this has happened," he said.

During a sentencing hearing last Thursday, defence barrister Scott Goodman, SC, said "no particular harm" had been identified by the unlicensed activity, though he conceded "no doubt there was a potential for persons to be harmed by this radiation".

He argued the company should be given a discounted sentence given the guilty plea cut seven days of trial time and saved 12 witnesses from being called.

Ian McLachlan, for the EPA, said the business was engaged in "deliberate flouting of the law" and that obtaining a license was a "relatively simple measure to amend".

The court heard the maximum financial penalty is $165,000. The company will be sentenced on August 13.

Company spokesman Cabral Douglas told Fairfax Media the former staff members' allegations were "false and defamatory".

"In fact, due to the latest innovations in the design of our mobile clinics, the standard of care these children are receiving exceed that of the vast majority of standard brick-and-mortar dental practices," he said.

He said the company had "opened all of our books" dating back to 2014 to Medicare investigators.

Mr Douglas said the legislation under which they were prosecuted was "obsolete" and he had raised the issue with Member for Baulkham Hills, David Elliott, who, he said, had promised to raise it with NSW Environment Minister Gabrielle Upton.

"It doesn't contemplate criminalising owners of the regulated material, particularly in clinical settings," he said. "We have mobile clinics providing services ... while the owners of the clinic could be located in another state.

"[The legislation has] failed to keep up with innovation and developments in the provision of medical services."

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